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Text reminders, digital health workers erase gap in breast cancer screening

Press releases may be edited for formatting or style | June 08, 2022 Women's Health
PEORIA, Ill., June 7, 2022 /PRNewswire/ -- Targeted text reminders and other interventions erased disparity in the rate of breast cancer screening between economically advantaged and disadvantaged patients, according to an OSF HealthCare study published in Population Health Management.

While screening has been shown to reduce breast cancer deaths, women who are economically disadvantaged are less likely to have breast cancer screening and more likely to die of the disease, often because the breast cancer isn't detected until it reaches a more advanced stage. Mammography screening rates plummeted during the COVID-19 pandemic, which only increased the disparity between economically advantaged and disadvantaged patients.

OSF HealthCare researchers analyzed the effectiveness of interventions created and supported by the OSF OnCall digital health team to reduce that disparity, with: text messages that included a link to schedule a mammogram and information about the importance of breast cancer screening; calls from a digitally-enabled community health worker (CHW) to help schedule mammograms and solve challenges such as transportation; and an invitation to a health fair offering on-site mammograms. Breast cancer screening rates more than doubled among Medicaid patients who received interventions.

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The National Comprehensive Cancer Network (NCCN) guidelines recommend annual mammography for most women beginning at 40 and earlier for women at higher risk for breast cancer.

"Previous studies have found that similar interventions help increase the rate of breast cancer screening, but not whether they would reduce disparities among different populations," said Jonathan A. Handler, MD, FACEP, FAMIA, senior author of the study and senior fellow, OSF Innovation at OSF HealthCare.

Dr. Handler added, "Our study found that these simple interventions provide an innovative approach to erase inequities in screening rates between economically disadvantaged and advantaged women, helping us meet our goal of providing equitable, excellent care to our financially and geographically diverse patient population."

The study included more than 4000 women in two groups: an economically disadvantaged group (those with Medicaid coverage), and an economically advantaged group (those with private commercial insurance). All were 41 or older, were aligned with an OSF primary care physician and appeared to be overdue for their mammogram – typically by two years or more. All with Medicaid were randomly assigned to one of three intervention arms and compared with a subset of commercially insured women randomized to receive no intervention

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